GEOG02: Global Health and Society
Winter Term 2013: 2A: T,TH 2-3:50, X-period W 4:15-5:05
Final Exam: 13 March 2013, 3:30pm
Classroom: Fairchild 101
Course Description:
Only a few decades ago, we were ready to declare a victory over infectious diseases. Today,
infectious diseases are responsible for major morbidity and mortality experienced throughout the
world. Even resource-rich countries are plagued by resistant “super-bugs” and antibiotic misuse.
This course will examine the epidemiology and social impact of past and present infectious
disease epidemics in the developing and developed world. True scenarios such as the
introduction of drugs to treat HIV/AIDS in sub-Saharan Africa will be considered from political,
ethical, medical, legal and economic perspectives. Lessons from past and current efforts to
control global infectious diseases will guide our examination of the high-profile infectious
disease pathogens poised to threaten our health in the future.
Open to all students. Limited to 40 students. Dist: INT or SOC. Adams/Butterly
Class Syllabus
Readings and recorded lectures are indicated beneath the topic to be discussed in class. ALL are expected
to have done the assignments. Primary research papers and review articles for each topic are included.
Introduction to Global Health: Overview of Infectious Disease Epidemiology
Tuesday, January 8
 Introduction to Global Health – L. Adams
1. Textbook of International Health, 3rd edition, Birn A, Pillay Y, Holtz T (eds.),
Oxford University Press, 2009, Introduction, pages 3-10.
2. Koplan et al. Towards a common definition of global health. Lancet, 2009 Jun 6,
373(9679);1993-5.
 Brief history of infectious diseases: humans, their environment and evolution – J.
Butterly
1. Listen to recording on Blackboard
2. Guns, Germs and Steel, Chapter 7: Lethal Gift of Livestock, pages195-214.
3. Principles and Practices of Infectious Diseases (Sixth Edition), A Molecular
Perspective of Microbial Pathogenicity, pages 3-12.
Thursday January 10
 Epidemiology of infectious disease – US perspective – J. Butterly
1. Listen to recording on Blackboard
2. Understanding Global Health, chapter 3, pages 37-60.
3. Morbidity and Mortality Weekly Report, Summary of Notifiable Diseases –
United States 2003, volume 52, No. 54; pages 1-14. (Just skim this reading)
4. OPTIONAL: Principles of Infectious Disease: Chapter 12 pages 161-171 –
Epidemiologic Principles.
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Epidemiology of infectious disease – global perspective – L. Adams
1. Jassal MS, Bishai WR. Epidemiology and challenges to the elimination of global
tuberculosis. Clin Infect Dis. 2010 May 15;50 Suppl 3:S156-64.
2. Reynolds SJ, Quinn TC. Setting the stage: current state of affairs and major
challenges. Clin Infect Dis. 2010 May 15;50 Suppl 3:S71-6.
3. World Malaria Report 2011. Summary and Key Points. WHO/Geneva.
Global Health Stakeholders and Systems
Tuesday, January 15
 Agencies, organizations and other stakeholders in global health – L. Adams
1. Textbook of International Health, 3rd edition, Birn A, Pillay Y, Holtz T (eds.),
Oxford University Press, 2009, pages 65-82, 89-93, 97-102, 109-119.
 Diseases of Neglect: Funding a Global Health Agenda – L. Adams
1. Understanding Global Health, chapter 14, pages 269-75.
2. Morris K. Time to overcome the neglect of neglected tropical diseases. Lancet Infect
Dis. 2010 Dec; 10(12):820-1.
Thursday, January 17
 Global Health Systems & Health Care Worker Shortage – Denise Anthony, PhD,
Associate Professor of Sociology
1. Understanding Global Health, chapter 15, pages 280-294.
Public Health Measures in Global Health
Tuesday, January 22
 Underpinning global health: food, nutrition, & disease – J. Butterly
1. Listen to recording on Blackboard
2. Understanding Global Health, chapter 6, pages 104-127.
 Impact of public health measures: water, waste disposal, hygiene – John Butterly
1. Listen to recording on Blackboard
2. UN Millennium Project 2005, Health Dignity and Development: what will it take?
Foreword through Chapter 2.
Thursday, January 24
 QUIZ #1
 Impact of medical/public health measures: vaccinations and antibiotic development –
L. Adams
1. Understanding Global Health, chapter 1, pages 1-18.
2. Morbidity and Mortality Weekly Report, Ten Great Public Health Achievements -United States, 1900-1999, volume 48, No. 12, April 2, 1999, pages 241-8.
3. Morbidity and Mortality Weekly Report, Achievements in Public Health 1990-1999:
Control of Infectious Diseases, volume 48, No. 29, July 30, 1999, pages 621-8.
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Tuesday, January 29
 Global Health Case #1: Dartmouth Involvement in Haiti
1. “Dartmouth Involvement in Haiti”
Thursday, January 31
 Race, Racism and Global Inequities – J. Butterly
1. Listen to recording on Blackboard
2. Fredrickson, George M., Racism: A Short History, 2002. (Book will be distributed
in class.)
 Disease Warriors: The War on Polio – (Rx for Survival video: Ch 2. India’s War on
Polio, Ch 6 Polio Spreads, Resistance Grows, Ch 7 Success on the Horizon, followed
by discussion) – L. Adams, J. Butterly & Peter Wright MD, Professor of Pediatrics
1. “Polio’s Last Stand?” Report by the Independent Monitoring Board, November
2012.
Child Health and Tuberculosis
Tuesday, February 5
 Epidemiology of the top causes of morbidity and mortality among children globally – J.
Butterly
1. Listen to recording on Blackboard
For the following articles you are only responsible for reading the abstracts.
2. Child Survival I, Lancet 2003;361:2226-34.
3. Child Survival II, Lancet 2003;362:65-71.
4. Child Survival III, Lancet 2003;362:159-64.
5. Child Survival IV, Lancet 2003;362:233-41.
6. Child Survival V, Lancet 2003;362:323-27.
 Tuberculosis: An ancient disease or a new threat? – L. Adams
1. Understanding Global Health, chapter 8, pages 149-159.
Thursday, February 7
 Tuberculosis: Epidemiology and Control – L. Adams
1. Zumla A et al. Reflections on the white plague. Lancet Infect Dis. 2009
Mar;9(3):197-202.
2. Chaisson RE & Martinson NA. Tuberculosis in Africa--combating an HIV-driven
crisis. N Engl J Med. 2008 Mar 13;358(11):1089-92.
3. Raviglione M & Smith I. XDR Tuberculosis — Implications for Global Public
Health. New England Journal of Medicine. 2007 Feb 15;356(7):656-9.
 Malaria : its history, current epidemiology, eradication and control – J. Butterly
1. Listen to recording on Blackboard
2. WHO International Publications, Chapter 7, Malaria, pages 132-151.
3. Principles and Practices of Infectious Diseases (Sixth Edition), Volume 2;
Plasmodium Species (Malaria), pages 3121-38.
Tuesday, February 12
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Ethics, medicine and research – James Bernat, Professor of Neurology
1. Understanding Global Health, chapter 16, The Four Principles of Ethics in Global
Health and Culture, pages 304-5.
2. Moral Standards for Research in Developing Countries: From “Reasonable
Availability” to “Fair Benefits.” Hastings Center Report May-June 2004, pages 1727.
3. Ethical Issues in the Design and Conduct of Clinical Trials in Developing Countries.
New England Journal of Medicine, Volume 345, No. 2, July 12, 2001, pages 139142.
4. Undue Inducement in Clinical Research in Developing Countries: Is It A Worry?
The Lancet, Volume 366, July 23, 2005, pages 336-340.
Global Health Case Study #2: “BRAC's Rural Tuberculosis Program” – L. Adams
1. Case Study “BRAC's Rural Tuberculosis Program
Thursday, February 14
 The Peruvian National Tuberculosis Control Program– J. Bayona, Director of Global
Health Programs and Practice, The Dartmouth Center for Health Care Delivery Science
 Vaccine Development – Professor Kendall Hoyt (more info to come)
Tuesday, February 19
 QUIZ #2
 H1N1 and pandemic influenza – well-prepared or over-reaction? – Jodie DionneOdom, Assistant Professor of Medicine & Elizabeth Talbot, Associate Professor of
Medicine, Infectious Disease and International Health Section
1. Zimmer SM & Burke DS. Historical perspective – Emergence of influenza A
(H1N1) viruses. N Engl J Med. 2009 Jul 16; 361 (3): 279-85.
Thursday, February 21
 Community-based Programs to address Multidrug-resistant TB – J Bayona, Director of
Global Health Programs and Practice, The Dartmouth Center for Health Care Delivery
Science
 History of HIV in Africa – Ford von Reyn, MD, Professor of Medicine, Infectious
Disease and International Health Section
1. Understanding Global Health, chapter 8, pages 159-175.
Responding to the HIV/AIDS Epidemic
Tuesday, February 26
1. Treating HIV: drug discovery and antiretrovirals in the US – Bryan Marsh, MD,
Associate Professor of Medicine, Infectious Disease and International Health Section
1. Sepkowitz KA. AIDS--The First 20 Years, New England Journal of Medicine,
Volume 344, No. 23, June 7, 2001, pages 1764-1772.
2. Sepkowitz KA. One Disease, Two Epidemics--AIDS at 25. New England Journal of
Medicine, Volume 354, No. 23, pages 2411-2414.
 When patents and patients collide: Introducing Antiretrovirals in Sub-Saharan Africa –
L. Adams
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Drug Patents Spotlight: Sharing Practical Knowledge About Pharmaceutical Patents,
Medecins Sans Frontieres, Geneva, Switzerland, May 2003, pages 1-27.
2. Africa’s AIDS War. The New York Times, March 10, 2001.
3. Drug Makers Drop South Africa Suit Over AIDS Medicine. The New York Times,
April 20, 2001.
4. Yale Pressed to Help Cut Drug Costs in Africa. The New York Times, March 12,
2001.
1.
Lessons Learned from Pandemic Influenza Responses and Smallpox Eradication
Thursday, February 28
 Health, Illness and Culture - Sienna Craig, PhD
Tuesday, March 5
 Eradicating smallpox: lessons learned: The Smallpox Campaign (Rx for Survival video
followed by discussion) – L. Adams &, J. Butterly
 Eradicating smallpox: stories from the field – Jason Weisfeld, MD, MPH, Adjunct
Instructor of Medicine, Infectious Disease and International Health Section.
1. Viruses, Plagues, and History: Past, Present and Future. Oldstone M. Oxford
University Press, Chapter 4, Smallpox; pages 53-101 (focus on pages 72-101)
Thursday March 7
 QUIZ #3
 Office hours for final projects
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General Course Details
Course Structure, Requirements, Materials, and Student Evaluation
Course Structure and Expectations for Students
The course will consist of lectures by faculty and guest faculty, and presentations of important
topics by pairs of students. X-hour sessions are generally not used, though group review sessions
may be scheduled upon request. A course textbook, Understanding Global Health, will be used.
Additional required reading materials will be posted on blackboard. PowerPoint slides from
each class and accompanying taped lectures for some of the class sessions will be posted on
blackboard.
Expectations for and grading of students consists of several elements:
 Three quizzes will be given during Weeks 4, 7 & 9 of the course (multiple choice,
true/false, matching, and short essays to cover the main points in lectures, the reading and
the class discussions) to be taken online during class.
 During the class, 3 case studies will be discussed in depth and classroom participation
during these sessions will be critically evaluated for evidence of prior preparation,
knowledge of the case and any other associated readings, and critical analysis. Grades for
classroom participation for these classes will be issued separately from overall in-class
participation.
 The final poster project should examine a key global health issue that that was not covered
in the class. Posters will require independent research and analysis with proper citing of all
reference materials utilized. You will work in groups of 3-4 on your posters. Posters will
be presented orally during the final exam period assigned to the class.
Students will be expected to do the daily readings in advance of class, meet all the assigned
deadlines, participate in a case discussion, take the assigned quizzes as scheduled and
produce a final poster.
Course Evaluation and Grading
The breakdown for final grades is as follows:
Quiz #1
Quiz #2
Quiz #3
3 Case Discussions (5% each)
Overall Class Participation
Final Poster Project
Total
15 %
15 %
15 %
15 %
10%
30 %
100%
Grading of quizzes, presentations, and the poster will be by both course faculty. Posters will be
graded as follows: 1/3 for the quality of the research, 1/3 for the quality of the presentation, and
1/3 for the quality of the analysis. Detailed instructions for preparing and presenting your poster
will be distributed in class.
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The assignment of letter grades will be based on a class curve. Students achieving 90% of total
course points will receive “some kind of A”; students failing to achieve 50% of course points OR
failing to complete all the course assignments in a timely fashion will receive a failing grade.
To encourage active learning and participation in the course, we have assigned 10% of the
final grade to class participation. In assessing this, we will look for evidence that the student is
intellectually engaged with the course, is providing interesting insights to peers and is
contributing to the general learning atmosphere of the course. Ways students can demonstrate
this include:
 Active participation in class with thoughtful questions and/or comments
 Indications through class participation that reading was completed and considered prior to
class
 Good use of office hours and the X-hour/review sessions
Taken together, this does provide you an opportunity to influence your final letter grade.
However, we will look for evidence that you have done these things throughout the course and
not just intermittently or towards the end of the course.
Course Materials
The REQUIRED textbook for the course Understanding Global Health is available for purchase
from Wheelock Books. ALL are expected to have done the reading for class. Primary research
papers and helpful review articles for each topic are also utilized. These additional selected
readings will be available on reserve and/or on the course web site (as pdf files). The course
website is accessible via Blackboard to enrolled students. Other required readings, PowerPoint
slides, web links, discussion boards and other limited access materials will be posted. Student
access to the Blackboard site will be by DND name and student ID number. For preparation of
the student group presentations, your group mentors will be able to help steer you to some
important reference information. A number of important textbooks may be kept on Baker library
reserve (listed above) for use in general class work and for use in the preparation of student
presentations.
Other Course Issues
Office Hours: Students are very much encouraged to utilize office hours for discussion and
questions and to work on their assigned presentations with their assigned faculty mentor. Office
hours for Professors Adams and Butterly will be announced at the beginning of the course.
X-hours: X-hours will be not be routinely utilized (we are aware many students have lab sessions
that prevent their participation during the X-hour). Based on student poll we may use X-hours
for review sessions. These will be scheduled early in the term.
Course Accommodations: Students with disabilities, including chronic diseases, learning
disabilities, and psychiatric disabilities are encouraged to discuss with the course faculty any
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appropriate accommodations that might be helpful. Please do this EARLY in the course. We
have worked closely with the Academic Skills Office in the past and can work with students to
find study methods, tutoring needs and exam accommodations for those who are eligible.
Dartmouth Academic Honor Principle: The Dartmouth College Student Handbook (page iii)
states: "Fundamental to the principle of independent learning are the requirements of honesty and
integrity in the performance of academic assignments, both in the classroom and outside.
Dartmouth operates on the principle of academic honor, without proctoring of examinations.
Students who submit work which is not their own or who commit other acts of academic
dishonesty forfeit the opportunity to continue at Dartmouth."
There are a number of situations in which a student in Geography 02 might find him or herself
tempted to violate the Academic Honor Principle. These situations include (but are not limited
to) the following:
a) The quizzes will be on-line and taken during weeks 4, 7 and 9. The quizzes will consist of
some multiple-choice answers, short answers and short essays.
b) Any form of plagiarism, namely the submission or presentation of work, in any form, that is
not the student's own without acknowledgement of the source, violates the Academic Honor
Principle. Students are responsible for the information concerning plagiarism and proper citation
found in the Sources: Their Use and Acknowledgement, available in the Deans' Offices and
online (http://www.dartmouth.edu/~sources/).
Honesty is the foundation of the academic pursuit of knowledge. In recognition of this, we will
not overlook any violations of the Academic Honor Principle. Indeed, the Faculty Handbook of
Dartmouth College states explicitly that College Faculty are obligated to report potential
violations of the Academic Honor Principle to the Dartmouth College Committee on Standards.
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